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1.
Medical Journal of Chinese People's Liberation Army ; (12): 746-750, 2020.
Article in Chinese | WPRIM | ID: wpr-849696

ABSTRACT

[Abstract] Objective To determine the prognostic value of thrombomodulin (TM) combined with thrombin-antithrombin complex (TAT) in patients with sepsis. Methods A retrospective analysis of the clinical data from 80 patients with sepsis who met the inclusion and exclusion criteria admitted to the 908th Hospital of Chinese PLA Logistical Support Force from May 2018 to July 2019. The conventional coagulation tests, thromboelastographic (TEG) parameters, TM, TAT, α2-plasmin inhibitor-plasmin complex (PIC, namely plasmin/alpha 2-antiplasmin complex, PAP) and tissue plasminogen activator-inhibitor-1 complex (t-PAIC) were collected within 2 hours at admission. According to the prognosis of 90 days, the patients were divided into survival group and death group and statistical analysis were performed. Results Compared with TM [11.7(8.8, 15.9) TU/ml] and TAT [11.3(7.0, 20.5) ng/ml] in the survival group, TM [20.2(14.1, 23.8) TU/ml] and TAT [17.7(11.8, 54.6) ng/ml] were significantly increased in the death group (P16.95 TU/ml combined with TAT>10.55 ng/ml. Conclusion TM combined with TAT can effectively judge the prognosis of sepsis patients and early identify sepsis related coagulation disorders.

2.
Philippine Journal of Health Research and Development ; (4): 18-26, 2020.
Article in English | WPRIM | ID: wpr-987766

ABSTRACT

Background@#Ironically, the hospital which is believed to be a healthy and safe place can be dangerous to health. Pollutants such as particulate matter 2.5 microns (PM₂.₅) can be present in hospital indoor air and may adversely affect the health of the hospital occupants. @*Objective@#Possible sources of indoor PM₂.₅ in an urban tertiary care hospital in the Philippines are identified and apportioned in this study. @*Methods@#PM₂.₅ measurements were conducted in two naturally ventilated wards (NVWs), two mechanically ventilated wards (MVWs), and a roof deck near the hospital. Mass concentrations with analytical uncertainties of thirteen elements (Al, Na, S, Si, Cl, K, Ca, V, Fe, Zn, Br, Hg, Pb) from PM₂.₅ measurements were utilized with Positive Matrix Factorization (PMF) receptor model to identify and apportion possible sources of indoor PM₂.₅. @*Results@#In NVWs and MVWs, four types of sources were identified including sodium and chlorine sources, crustal emissions, anthropogenic sulfur sources, and road dust. Cleaning agents used in the hospital were identified as an anthropogenic indoor source of sodium while the other factors mainly came from outdoor sources. @*Conclusion@#The contribution of anthropogenic outdoor pollutants such as road dust and sulfur sources to indoor PM₂.₅ are highlighted in the study. The types of both indoor and outdoor sources of indoor PM₂.₅ can be influenced by the type of ventilation.


Subject(s)
Respiration, Artificial , Air Pollution, Indoor
3.
Ciênc. cuid. saúde ; 18(4): e44056, 20190804.
Article in Portuguese | LILACS, BDENF | ID: biblio-1120055

ABSTRACT

Objective: To reflect about care actions toward late preterms and their mothers, based on good practices for newborn care. Methods: Reflexive-theoretical essay that discusses care actions in the first 24 hours of life of late preterms and the connection of said actions with good practices for newborn care. Results: It is worth highlighting the importance of care in the first hour of life of late preterms, especially stimulation through skin-to-skin contact, breastfeeding and thermoregulation. Further Considerations: Informing families about late prematurity is an aspect of great relevance to these newborns' health, along with including assistance-oriented actions to be taken by several professionals in view of the specific care needs of late preterms.


Objetivo: Refletir acerca das ações de cuidados aos prematuros tardios e suas mães apoiado nas boas práticas para a atenção ao recém-nascido. Métodos: Ensaio teórico-reflexivo, o qual discute as ações de cuidado nas primeiras 24 horas de vida dos prematuros tardios e sua relação com as boas práticas para a atenção ao recém-nascido.Resultados: Destaca-se a importância do cuidado na primeira hora de vida de prematuros tardios, especialmente o estímulo ao contato pele a pele e à amamentação, e a termorregulação. Considerações Finais: Fornecer informação à família sobre a prematuridade tardia é um dos aspectos de grande relevância no cuidado a estes recém-nascidos e incluir ações assistenciais de diversos profissionais frente à necessidade dos cuidados aos prematuros tardios.


Subject(s)
Infant, Premature , Neonatal Nursing , Hospitals, Maternity , Breast Feeding , Perinatal Care
4.
Article | IMSEAR | ID: sea-200167

ABSTRACT

Background: Use of inappropriate medication is an important problem in present geriatric clinical practice. No specific potentially inappropriate medications (PIM) tools are available considering the availability of drugs in India. Aim and objective were to assess prevalence and pattern of potentially inappropriate medication (PIM) use in elderly inpatients by updated Beers criteria 2015 and EU(7) PIM list 2015.Methods: This cross-sectional study was carried out on medical records of elderly patients (?65 yrs) admitted in the internal medicine wards and intensive care units (ICU) over a period of 6 weeks. The medications were evaluated for the PIM use as per Beers criteria and EU(7) PIM list.Results: A total of 225 patients (mean age- 71.48 yrs) were admitted in internal medicine wards and ICU during study period. Total 184 PIM belonged to 33 different medications were used during study period. The prevalence of PIM in internal medicine wards and ICUs were 51.96% and 57.14%, respectively. The prevalence of PIM was significantly higher with the EU(7) PIM list than Beers criteria (49.77% vs. 21.77%) [p<0.0001]. The commonly prescribed PIM were dextromethorphan (13.33%), ranitidine (11.11%) and glipizide (10.22%).Conclusions: Elderly patients frequently receive PIM. EU(7) PIM list identifies more PIM among elderly inpatients than Beers criteria.

5.
West Indian med. j ; 67(1): 57-59, Jan.-Mar. 2018. tab, graf
Article in English | LILACS | ID: biblio-1045818

ABSTRACT

ABSTRACT Objective: Methicillin-resistant Staphylococcus aureus (MRSA) is associated with soft tissue infections in surgical patients. In severe cases, it may result in pneumonia, septicaemia and osteomyelitis. Limited data are available with regard to its prevalence and associations in the Caribbean. This study aimed to assess the prevalence of MRSA in patients hospitalized in the surgical wards of the Port-of-Spain General Hospital (POSGH), Trinidad and Tobago, and determine associated risk factors. Methods: Over the period of April 1 to August 1, 2013, all patients from the surgical wards of the POSGH who had had wound swabs taken were identified. Demographic data included duration of hospital stay, surgical and medical history, antibiotic use and type of wound swab. Microbiological reports were then retrieved and analyses done. Results: A total of 153 patients had wound swabs taken. There were 38 patients (24%) infected with Staphylococcus aureus, with 15 (39.5%) growing MRSA. Increased susceptibility to MRSA was associated with age, gender, ethnicity, duration of hospital stay, co-morbidities, previous antibiotic use, previous surgery and the type of wound (p < 0.05). Conclusion: The prevalence of MRSA in the surgical wards of the POSGH was 39.5% of Staphylococcus aureus isolates. Risk factors included the age range of 60-69 years, patients with co-morbidities, hospital stays of longer than one week, previous surgery and prior use of antibiotics. We recommend more awareness of this problem in the practice of Caribbean medicine to improve infection rates.


RESUMEN Objetivo: El estafilococo dorado resistente a la meticilina (EDRM) se asocia con infecciones de tejidos blandos en pacientes quirúrgicos. En casos severos, puede dar lugar a pulmonía, septicemia y osteomielitis. Los datos disponibles con respecto a su prevalencia y asociaciones en el Caribe son limitados. Este estudio persigue evaluar la prevalencia de EDRM en pacientes hospitalizados en las salas quirúrgicas del Hospital General de Puerto de España (POSGH, siglas en inglés) en Trinidad y Tobago, y determinar los factores de riesgo asociados. Métodos: Durante el período del 1 de abril al 1 de agosto de 2013, fueron identificados todos los pacientes de las salas quirúrgicas del Hospital POSGH a quienes se les había practicado frotis de las heridas. Los datos demográficos incluyeron la duración de la estadía hospitalaria, las historias clínicas y quirúrgicas, el uso de antibióticos, y el tipo de frotis de la herida. Luego se obtuvieron los informes microbiológicos y se realizaron los análisis. Resultados: A un total de 153 pacientes se le tomaron frotis de heridas. Hubo 38 pacientes (24%) infectados con estafilococos dorados, de los cuales 15 (3.5%) presentaban EDRM creciente. El aumento de la susceptibilidad a EDRM se asoció con la edad, el género, la etnicidad, la duración de la estadía hospitalaria, las co-morbilidades, el uso previo de antibióticos, las cirugías previas, y el tipo de herida (p < 0.05). Conclusión: La prevalencia de EDRM en las salas quirúrgicas del Hospital POSGH fue 39.5% de aislados de estafilococos dorados. Los factores de riesgo incluyeron un rango de edad de 60-69 años, pacientes con co-morbilidades, estancia hospitalaria de más de una semana, cirugía previa, y uso previo de antibióticos. Recomendamos tomar más conciencia de este problema en la práctica médica en el Caribe a fin de mejorar las tasas de infección.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Staphylococcal Infections/microbiology , Surgical Wound Infection/microbiology , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Trinidad and Tobago , Prevalence , Risk Factors , Hospitals, General
6.
Journal of Medical Informatics ; (12): 43-46, 2018.
Article in Chinese | WPRIM | ID: wpr-700751

ABSTRACT

Based on Hospital Information System (HIS),mobile terminal devices are used to realize the application of medical Internet of Things (IoT) in clinical nursing in wards,including intelligent basic data collection and monitoring system of medical IoT,intelligent infusion management system and other aspects,to expand and extend nurse's work to sickbeds and enhance nursing efficiency.

7.
Modern Clinical Nursing ; (6): 29-32, 2018.
Article in Chinese | WPRIM | ID: wpr-698860

ABSTRACT

Objective To investigate the effect of collaborative assessment and management on skin of high-risk pressure ulcer patients by nurses from operating room and wards. Methods 709 high-risk pressure ulcer patients who underwent surgical operations in our hospital were selected as the control group from January to June 2016.The 3S pressure ulcer risk assessment form was used to evaluate the skin of the operated patients.Another 680 high-risk pressure ulcer patients were selected as the observation group from July to December in 2016.The skin evaluation and pressure ulcer protection measures in the observation group were the same as those in the control group.The assessment was done by the nurses from the operating room and the wards separately.According to the evaluation form, the nurses in the operating room explained the patient's skin condition to the ward nurses in details, and then they cooperated in managing the postoperative skin of the patients. The two groups were compared in respect of the incidence of pressure ulcers at the time points of postoperative 24h,48h and 72h. Results There was no significant difference in the incidence of pressure ulcers after operation between the two groups(P>0.05).The incidence of pressure ulcers in the observation group was significantly lower than that of the control group at the time points of 24h, 48h and 72h after operation (P<0.05). Conclusion The collaborative assessment and management of skin for surgical patients with high-risk pressure ulcer by the nurses from both operating room and wards can effectively prevent the occurrence and development of pressure ulcers,worthy of clinical application.

8.
Chinese Journal of Practical Nursing ; (36): 1766-1771, 2018.
Article in Chinese | WPRIM | ID: wpr-697240

ABSTRACT

Objective To establish a nursing-sensitive quality indicator system in orthopedic wards based on the structure-process-outcome theory, so as to guide clinical nursing. Methods Based on structure-process-outcome theory, the indicator definition and weight were identified by literature review, expert group discussion, Delphi method and Hierarchy analysis. Results The returning rates of questionnaires in the first and second round expert consultation were 94.87%(37/39) and 89.74%(35/39), respectively. The authority coefficient of the experts was 0.88,and the coordination coefficient of experts' opinion was 0.309.The program included 3 first indexes,14 second index, and 83 items. Conclusion The result of the study is scientific reliable and credible, Whichcan provide evaluation for the Clinical nursing operation.

9.
Rev. bras. enferm ; 71(supl.3): 1351-1357, 2018. graf
Article in English | LILACS, BDENF | ID: biblio-958745

ABSTRACT

ABSTRACT Objective: To define a theoretical framework to guide the systematization of nursing care in a maternity unit in the South of Brazil. Method: This was the preliminary stage of a qualitative methodological study, based on an educational activity and the assumptions of Paulo Freire, involving 15 nurses, between August and November 2015. The aim of data analysis was to identify emerging themes. Results: The following themes emerged: knowledge of nurses about nursing theories; barriers to implementing and systematizing nursing care; the importance of a framework to guide practice and; educational activities as opportunities to systematize nursing care. Conclusion: The discussion process involved in establishing the theoretical framework enabled reflections about nursing practices, reinforcing the importance of theoretical frameworks to guide work processes and enhance quality of care.


RESUMEN Objetivo: Definir el referencial teórico de respaldo para implantar la sistematización de la atención de enfermería en maternidad del sur de Brasil. Método: Etapa preliminar de estudio metodológico, de abordaje cualitativo de datos, realizado a partir de práctica educativa guiada por los supuestos de Paulo Freire, con 15 enfermeras, entre agosto y noviembre de 2015. El análisis de datos buscó identificar los temas emergentes. Resultados: Como temas emergentes fueron hallados: Conocimiento de las enfermeras sobre Teorías de Enfermería; Dificultades para implementación de sistematización de la atención de enfermería; Importancia del referencial para respaldar la práctica; y La práctica educativa como posibilidad de concreción de la sistematización de la atención de enfermería. Conclusión: El proceso de discusión para obtener el referencial teórico permitió reflexiones sobre la práctica, reforzando la importancia de un referencial teórico para orientar su proceso de trabajo y la optimización de la calidad de la atención.


RESUMO Objetivo: definir o referencial teórico para sustentar a implantação da sistematização da assistência de enfermagem em uma maternidade do sul do Brasil. Método: trata-se da etapa preliminar de um estudo metodológico, com abordagem qualitativa dos dados, realizada a partir de uma prática educativa, guiada pelos pressupostos de Paulo Freire, com 15 enfermeiras, no período de agosto a novembro de 2015. A análise de dados buscou identificar os temas emergentes. Resultados: como temas emergentes foram elencados: Conhecimento das enfermeiras sobre Teorias de Enfermagem; Dificuldades para implementação da sistematização da assistência de enfermagem; Importância do referencial para subsidiar a prática e; e A prática educativa como possibilidade para efetivação da sistematização da assistência de enfermagem. Conclusão: o processo de discussão para a obtenção do referencial teórico permitiu reflexões sobre a prática, reforçando a importância de um referencial teórico para guiar o processo de trabalho e fortalecimento da qualidade da assistência.


Subject(s)
Humans , Nursing Theory , Maternal Health Services/standards , Nurses/psychology , Brazil , Qualitative Research
10.
China Pharmacy ; (12): 3102-3105, 2017.
Article in Chinese | WPRIM | ID: wpr-618239

ABSTRACT

OBJECTIVE:To change the drug management mode in wards,promote drug use for patients timely and rationally. METHODS:Automated dispensing cabinet(ADC)was used to manage the drugs in some wards in our hospital,and introduce its use practice from aspects of drug management mode,pharmacists'management to ADC,related measures when using ADC manag-ing ward drugs,effect evaluation after using ADC(using species of base drugs,average time of dispensing temporary medical or-ders,drug returning times in 5 wards before and after using ADC as indexes),etc. RESULTS:Drug management method was es-tablished in ADC by screening drugs into the cabinet and developing process of taking drugs out. And pharmacists had achieved drug management in wards by establishing drug lists,conducting replenishment and inventory management,developing emergency plan,enhancing supervision and inspection,etc. Compared with before using ADC,average species of base drugs in the 5 wards increased from 65.8 to 157.2;average time of dispensing temporary medical orders dropped from 24.5 min to 5.8 min;and average drug returning times in 3 months decreased from about 200 times to about 20 times(P<0.05 or P<0.01). CONCLUSIONS:Us-ing ADC in wards for drug management has not only improved use convenience of drugs in wards,working efficiency of nurses as well as pharmaceutical care quality of pharmacists,but also has changed drug management mode and promoted rational drug use of patients.

11.
China Pharmacy ; (12): 3960-3964, 2017.
Article in Chinese | WPRIM | ID: wpr-661981

ABSTRACT

OBJECTIVE:To standardize the ward rescue and essential drugs quality management in wards,and reduce the med-ication risk of patients. METHODS:Failure mode and effect analysis(FMEA)was used to analyze the inspection items and failure modes of quality management of ward rescue and essential drugs. According to scoring the possibility,severity and detectability de-gree of the failure modes and calculating the risk priority number(RPN),failure modes that should be given priority improvement were quantified and determined,improvement measures were developed and conducted,and management effects were evaluated af-ter 6 months. RESULTS:12 failure modes were determined,including the residue treatment of narcotic and the first-class psycho-tropic drugs was not recorded,drug storage temperature was not up to standard and drug expired,etc. Improving related systems, enhancing the inspection management,cold chain management,daily management and other measures were implemented and con-ducted. After 6 months,the top 3 items with the highest RPNs were dropped from 320,240,216 score to 16,16,27 scores,re-spectively,all in a relatively low risk area. Numbers of failure mode event were dropped from 1869 to 218,dropping by 88.3%. CONCLUSIONS:According to qualifying the failure modes in ward rescue and essential drugs quality management by using FMEA in our hospital,the management items with the highest risk has determined and improved,the medication risk of patients has significantly reduced.

12.
China Pharmacy ; (12): 3960-3964, 2017.
Article in Chinese | WPRIM | ID: wpr-659160

ABSTRACT

OBJECTIVE:To standardize the ward rescue and essential drugs quality management in wards,and reduce the med-ication risk of patients. METHODS:Failure mode and effect analysis(FMEA)was used to analyze the inspection items and failure modes of quality management of ward rescue and essential drugs. According to scoring the possibility,severity and detectability de-gree of the failure modes and calculating the risk priority number(RPN),failure modes that should be given priority improvement were quantified and determined,improvement measures were developed and conducted,and management effects were evaluated af-ter 6 months. RESULTS:12 failure modes were determined,including the residue treatment of narcotic and the first-class psycho-tropic drugs was not recorded,drug storage temperature was not up to standard and drug expired,etc. Improving related systems, enhancing the inspection management,cold chain management,daily management and other measures were implemented and con-ducted. After 6 months,the top 3 items with the highest RPNs were dropped from 320,240,216 score to 16,16,27 scores,re-spectively,all in a relatively low risk area. Numbers of failure mode event were dropped from 1869 to 218,dropping by 88.3%. CONCLUSIONS:According to qualifying the failure modes in ward rescue and essential drugs quality management by using FMEA in our hospital,the management items with the highest risk has determined and improved,the medication risk of patients has significantly reduced.

13.
Medisan ; 20(8)ago.-ago. 2016. ilus
Article in Spanish | LILACS, CUMED | ID: lil-794094

ABSTRACT

Se realizó un estudio del ambiente electromagnético en 2 departamentos de electroterapia del municipio Palma Soriano de Santiago de Cuba, a fin de obtener el patrón de distribución para diferentes modos de operatividad y explotación del equipamiento médico-terapéutico. Para la caracterización electromagnética de los ambientes evaluados se elaboró un protocolo de medición a partir del análisis de normas internacionales y se empleó un medidor isotrópico que mostró los resultados a través de mapas de contorno. El equipo electromédico Magnetomed, modelo 7200 fue el que más aportó, aunque el valor máximo de la inducción magnética obtenido (19,7 µT) estuvo por debajo del límite de exposición establecido y por encima del límite de exposición sugerido por el Grupo de Trabajo Bioiniciativa. Se recomienda limitar la permanencia de personas en sus proximidades mientras está en funcionamiento.


A study of the electromagnetic environment was carried out in 2 electrotherapy departments of Palma Soriano in Santiago de Cuba, in order to obtain the distribution pattern for different operability ways and exploitation of the medical-therapeutic equipment. For the electromagnetic characterization of the evaluated environments a measurement protocol was elaborated starting from the analysis of international standards and an isotropic measure was used that showed the results through contour maps. The electro-medical device Magnetomed, model 7200 was the one that contributed the most, although the maximum value of the obtained magnetic induction (19.7 µT) was below the established exhibition limit and above the exhibition limit suggested by the Bioiniciativa Work Group. It is recommended to limit the permanency of people around, while it is in operation.


Subject(s)
Electrical Equipment and Supplies , Health Facility Environment
14.
China Pharmacy ; (12): 2660-2662, 2016.
Article in Chinese | WPRIM | ID: wpr-501085

ABSTRACT

OBJECTIVE:To promote standard management of drugs in ICU area. METHODS:The change of work mode in ICU area of our hospital was analyzed and compared after the application of automated drug dispensing system(ADDS)as well as the change of related indicators 3 months before and after the application of ADDS;the effect of ADDS was evaluated. RESULTS& CONCLUSIONS:After the application of ADDS,the management of base drugs changed from open management to intelligent, closed-off and authority management;drug storage and cost management became more scientific,and staff allocation became more optimal. Under the condition of zero difference in the number of medical orders,initial medication time shortened from 170 min to 131 min (P<0.05),time of daily drug preparation and drug repercussion shortened from (81.20 ± 3.56)min to (30.04 ± 7.55) min,and (9.18 ± 2.79)min to (6.47 ± 4.66) min (P<0.05). The application of ADDS can improve work efficiency,standardize drug management,promote medical safety,and provide reference for initiating a new mode of drug management in wards.

15.
Chinese Journal of Practical Nursing ; (36): 702-706, 2016.
Article in Chinese | WPRIM | ID: wpr-496020

ABSTRACT

Objective To build the dynamic management system of nursing staff allocation in general pediatric wards based on working hours measurement.Methods 30 general pediatric wards of 25 general or children hospitals of upper first class were selected to measure working hours.Depending on the average nursing hours required for pediatric patients in different care levels by each positions,we achieved the nursing staffing formulas.Results 7 nursing posts under double-shift turn and three-shift turn were collected.The average hour that nursing posts provide for one different nursing grade patient was made out.Taking a ward which had 20 patients as nursing grade one and 20 patients as nursing grade two for example,it would need 8-9 responsible nurses,2-3 long night shift nurses,1-2 general affairs nurses,2 night assistance nurse,1 day assistance nurse by double-shift turn,meanwhile,it would need 8 responsible nurses,4 early night shift nurses,3 late night shift nurses,1-2 general affairs nurses by three-shift turn.Conclusions Using the formulas based on measurement of working hours to calculate the number of nursing staff could provide a way to help the managers.

16.
International Journal of Laboratory Medicine ; (12): 1762-1764, 2016.
Article in Chinese | WPRIM | ID: wpr-494873

ABSTRACT

Objective To investigate the specimen source and drug resistance in the strains of Acinetobacter baumannii isolated from the submitted samples in the neurosurgery wards of our hospital during 2011-2014 in order to provide the reference for clini‐cal treatment and nosocomial infection control .Methods A retrospective analysis was performed on the clinical data of clinical dis‐tribution and antibacterial drugs sensitivity in 404 non‐repeated strains of Acinetobacter baumannii isolated from the samples of neurosurgical patients .Results The mainly specimen source of Acinetobacter baumannii isolated from neurosurgical patients was sputum and cerebrospinal fluid ,accounting for 89 .1% and 7 .9% respectively .Acinetobacter baumannii isolates showed the lowest resistance rates to minocycline and cefoperazone/sulbactam (28 .6% and 31 .8% respectively) .The resistance rates to imipenem and meropenem were 79 .4% and 83 .2% respectively ;the resistance rate to other antibacterial drugs exceeded 69 .0% .Conclusion Acinetobacter baumanii strains isolated from the neurosurgery department have higher resistance rates to many kinds of antibacteri‐al agents ,minocycline and cefoperazone/sulbactam still has good in vitro antibacterial activity against Acinetobacter baumanii .Clinic should strengthen the management of antibacterial agents ,increases the rate of drug susceptibility test and rationally uses the anti‐bacterial drugs .

17.
Palliative Care Research ; : 311-315, 2016.
Article in Japanese | WPRIM | ID: wpr-378211

ABSTRACT

Objective: To determine nurses’ and care workers’ role in caring for the dying on wards for recuperation under health insurance. Methods: The analysis was performed using semi-structured interviews involving 9 nurses and care workers working on wards for recuperation under health insurance and having experience of caring for dying patients. Results: As for nurses’ roles in caring for dying patients, 6 categories were extracted, including ‘support patients’ families to have a feeling that they were fully involved in the process of dying’. As for care workers’ roles in caring for dying patients, 5 categories were extracted, including ‘support nurse through the care worker activities’. Conclusion: In order to provide quality care for the dying, it is important to put the following points into practice: providing feedback and seculity on effects of daily life support, the provision of opportunities to enhance the independence of the care worker.

18.
Singapore medical journal ; : 18-21, 2016.
Article in English | WPRIM | ID: wpr-276697

ABSTRACT

<p><b>INTRODUCTION</b>The study aimed to determine the prevalence and documentation of delirium among the elderly and if the Clock Drawing Test (CDT) can be used to predict which patients had delirium on admission and those who may develop delirium during their stay in acute medical wards.</p><p><b>METHODS</b>A single researcher performed the Mini-Mental State Examination (MMSE) and CDT on admission and discharge of 57 elderly adults at the National University Hospital, Singapore. Delirium was defined as a ≥ 3-point improvement or ≥ 2-point decline in MMSE scores from admission to discharge, where a fall denotes development of delirium and a rise denotes resolution. The case notes of the same patients were reviewed for documentation of delirium. All inpatients from two acute medical wards were examined. One CDT score and a pair of MMSE scores were collected from each patient.</p><p><b>RESULTS</b>A total of 57 patients (28 male, 29 female) were involved in the study. Their mean age was 76.0 ± 8.7 years. The prevalence of delirium based on MMSE scores was 40.4%; 16 patients had delirium on admission while seven developed delirium during their inpatient stay. However, delirium was documented in the case notes of only 7 (30%) of the 23 patients. CDT score was better than baseline MMSE score at predicting a decline in MMSE score.</p><p><b>CONCLUSION</b>The prevalence of delirium in the acute medical setting is high but underdiagnosed. The CDT may be a good screening tool to identify patients at risk of delirium during their inpatient stay. Baseline cognition screening should be performed in every elderly patient admitted to hospital.</p>


Subject(s)
Aged , Female , Humans , Male , Middle Aged , Cognition , Physiology , Delirium , Diagnosis , Epidemiology , Diagnostic Errors , Follow-Up Studies , Inpatients , Neuropsychological Tests , Pilot Projects , Prevalence , Prognosis , Retrospective Studies , Risk Factors , Severity of Illness Index , Singapore , Epidemiology
19.
China Pharmacist ; (12): 1947-1950, 2015.
Article in Chinese | WPRIM | ID: wpr-670102

ABSTRACT

Objective:To investigate the residual narcotics for injection after used in wards in order to provide evidence for the use standardization of narcotics for injection. Methods:A retrospective research method was adopted. Totally 5 288 prescriptions including narcotic drugs for injection in wards were collected and analyzed from June to August in 2014. Results:Only four kinds of narcotics for injection were used in wards, the residual proportion of morphine hydrochloride injection and pethidine hydrochloride injection was 2%, and that of fentanyl citrate injection was 0. 2%. Conclusion:The residue of narcotics for injection in wards is very little, and the specifi-cations of the medication in our hospital meet the demands of clinics. The research is beneficial to improving the management efficiency.

20.
Chinese Journal of Hospital Administration ; (12): 310-313, 2014.
Article in Chinese | WPRIM | ID: wpr-446931

ABSTRACT

By means of literature review,expert interviews and experts sorting,the authors identified three approaches of medical humanities care,and applied them to three clinical departments of top ten incidence of medical disputes of the hospital in 2012.These departments have similar number of beds,and covered both internal medicine and surgery departments.The purposes of the study are to evaluate the effects of medical humanities care measures in clinical departments,and to make relevant thoughts and suggestions.

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